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HomeMy WebLinkAbout16955-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Buildin§ Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. z-16858 Date May 10, 1988 THIS CERTIFIES that the building PORCH ADD IT ION Lo t' fPro t 1265 Wunneweta Road Cutchogue, New York _ca_zen o per.yHouse .......................................................... No. Street County Tax Map No. 1000 Section ... ! J .1 ...... Block 4 .Lot 2 8 Subdivision ............................... Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore filed in this office dated May 6, 1988 pursuant to which Building Permit No. 16955 Z dated ..... .~.a.y...I.0.:..I .9.8.8. ......... was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... UN-HEATED ENCLOSED PORCH ADDITION TO EXISTING ONE FAMILY DWELLING The certificate is issued to ROBERT HANSEN ..................... .................... of the aforesaid building. Suffolk County Department of Health Approval .... .N./.A. .................................. UNDERWRITERS CERTIFICATE NO ..... ?.E.N.D..I ~.G..Z..5/.8./. 8..8 .......................... PLUMBERS CERTIFICATION DATED: N/A ........... Rev. 1/81 TOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERA41T (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) 16955 N~ .... ~..~....~:~....~Li~... · , ..... ~~__...~/~.......,,~.~...~......= ~ ,,~. ,~~.~......~--.4~..-.-~..,~.~.-~.~f? .... ~ ...... o, prem,,es ,~ated a, ./..~.~:.~~~.....~.~.~ .............................................. Caun~ Ta× Map No. ,000 Sect,an .......... //./.. ..... B,o~k .......... ...~.... .... Lo, ,o ............ ~..~ pursuant to application dated ........... ~ .................................. , 19....~::m..~?and approved by the Building Inspector. Fee S.~..ff.~.. Rev. 6/30/80 FORM NO, 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 765 - i802 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions A, This application must be filled in typewriter OF{ ink, and submitted m ~ to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of properW with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2.Final approval of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3.Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5.Submit Planning Board approval of completed site plan requirements where applicable. B. For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land uses: t. Accurate survey of pzOperty showing all property lines, streets, buildings and unusual natural or topographic features. 2.Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. C. Fees: Additions $25.00 POOLS $25 . 00 ALTERATION $25.00 1. Certificate of occupancy New Dwelling~$25.Q0, Accessory.i$iO.O0 Business $50.00 2. Certificate of occupancy on pre-existing dwelling $ 5 0.0 0 3. Copy of certificate of occupancy $ 5.00, over 5 years $10.00 4.Vacant Land C.O. $ 20.00 5.Updated C.O. $ 50.00 Date .......................... NewConstruc tion ...... Old or Pre-existing Building ............ Vacant Land ............. Location of Property . 1265 Wunnewefa Road Cutchogue, N.Y. House No. Street Ham/et ROBERT HANSEN Owner or Owners of Property ............................................................ County Tax Map No. 1000 Section . ] I ] 4 28 .............. Block ............... Lot ................ Subdivision ................................. Filed Map No ........... Lot No .............. 5/10/88 · Robe.r.t. Hansen Permit No.. !. 6. .9 .5.5. . Z.. Date of Permit · ......... Applicant ................. Health Dept. Approval ........................ Labor Dept. Approval ................ PENDING Underwriters Approval ........................ Planning Board Approval ..................... . Request for Temporary Certificate ..................... Final Certificate ....................... Fee Submitted $ 25.00 Construction on above described building and permit meets all applicable codes and regulations. Rev. 10-10-78 Applicant ......... P, b'B']~ ~ ~' 'H',~ l~ ~ k N' ........................... 765-1802 BUILDING DEPT. INSPECTION FOUNDATION 1ST [ ] ROUGH PLBG. FOUNDATION 2ND [ ] INSULATION FRAMING ?]~AL REMARKS: ~ ~__~, c~ DATE~ i~/~ /~ INSPECTOR~~/~ FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. 11971 TEL.: 765-1803 E1 '' ', 19~'~' Approved . .~. ......... 19 .. ennit No ........ Disapproved a/c ..................................... ................................ ,APPLICATION FOR BUILDING PER~IT BOARD OF HEALTH ............ 3 SETS OF PLANS ............ SURVEY ..................... CHECK ...................... SEPTIC PORN ................ NOTIFY CALL .... ~ ¢.~. ~? 7;~f .... MAIL' TO: Date ....... · ........... , 19... INSTRUCTIONS a. Tiffs application must be completely filled in by Wpewriter or in ink and submitted to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or areas, and giving a detailed description of llyout of property must be drawn on the diagram which is part of this appli- cation. e. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit shah be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. ~ k~ APPLICATION IS HEREBY MADE to the Building Department for ~g}~lnce of a Building Permit pursuant to the Building Zone Ordinance ,q.~f ~.,e:~Town-of. g,~uthold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the coffi{lilct~sh "of bi~ildings, additions or alterations, or for/'emoval or demolition, as herehx described. The applicant agrees,l~o~.,cxl, rn~pt~,vitl~aJl applic~Ble"laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on p~emises and in building for necessary inspections. ,',,; ~ ~.~.~ ~'~; ' ' ' '?". (Signature o~applicant, orname, ifacorporanon) 9~.a,~ ,~*,'~, ~ c; ~ , - s~ ...= ' (Mailing address of applicant) State whether a~,plic,antois owner lesZ~'e "a~e~t}~ architect, engineer, general contractor, electrician, plumber or builder. ....:; ....... ............ 'rS',:,~' ' ' ~-~' ', '," ;,; ' - '" ' ,,\& ,, ~ame oI owner ,o..1 gr~¢!se~ -~,~0,'" ,'. ~' ........... ' .................................................... ...... ~'>'"' ~> "~ ' ~ ' ' ' (as on the tax roll or latest deed) If applicant is a ~:6t'~6ratietfi?~l~natu~e of duly authorized officer. (Name and title of corporate officer) Builder's License No ...... 5..'..e~/...~.>. ........... Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... 1. Location of land on which proposed work will be done .................................................. ......... ....... . .C... House Number Street Hamlet County Tax Map No. 100~0 Section .. [ 1 ./ ............. Block ........ .~ ......... Lot ..... .~: ~. ......... Subdivision..~, .~.~..Q :..~. g~..h ~ ................. Filed Map No ............... Lot ............... (Nm~e) 2. State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy . . .~'..~vs.,~.~...~.'.~y ............................ Intended use and occupancy . ..~...~.~....c~,., ./.~ .~.. ~A-~.'~.. ............ b. / 3. Nature of work (check which applicable): New Building ..... ' ..... Addition ..~. ....... Alteration .......... Repair .............. Rem?al .............. Demolition .............. Other Work ............... !9 : i'~ ~ (Description) 4 .... .~..C).© i Fee · Estimated Cost .................................................................... (to be paid on filing this application) 5. If dwelling, number of dwellingiunits ............... Number of dwelling units on each floor ................ If garage, number of cars .... 2 ............................. i .................................... 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use .................... 7. Dimensions of existing structures, if any: Front ............... Rear ... ] .......... Depth .............. tleight ............... Number of Stories ....................................................... Dimensions of same structure with alterations or additions: Front ................. Rear ................. Depth ...................... Height ...................... Number of Stories ..................... 8. Dimensions of entire new construction: Front .. J.~. .......... Rear ... [6'- .......... Depth . 20 .......... Height ............... Nurfiber of Stories ...I .................................................... 9. Sizeoflot: Front .......... i ........... Rear ...................... Depth ...................... 10. Date of Purchase .......... ~ .................. Name of Former Owner ............................. 11. Zone or use district in which premises are situated ..................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ................................ 13. Will lot be regraded ........ ~ ................... Will excess fill be removed from premises: Yes No 14. Name of Owner of premises .. ! ................. Address ................... Phone No ................ Name of Architect ......... : ................. Address ................... Phone No ................ Name of Contractor ........ i ................. Address ................... Phone No ............ :. PLOT DIAGRAM Locate clearly and distinctly ali buildings, whether existing or proposed, and. indicate all set-back dimensions from property lines. Give street and blocklnumber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, COUNTY OF APPRGVED AS NOTED NOTIFY g U~I~ING 7fl6-1802 9 AM TO 4 ~ I:OR THE FOLLOWING INSPECTIONS: 1. FOUNDATION . TWO REOUIRED FOR POURED CONCRE'~ ROUGH. FRAMING & RUJMSING 3. INSULATION 4. FINAL CONSTRUCTION MUST SE COMPLETE FOR ALL CONSTRUCTION SHALL THE REOUtRIiMENT$ OF ?fie N.Y. STATE CONSTRUCTION & ENERGY CODES. NOT REBPONBISf. E FOR DESIGN OR CONSTRUCTION ERRORS ............................. .................... being duly sworn, deposes and says that he is the applicant (Name of individual sign:lng contract) above named. He is the ............................................................................ (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that alt statements contained in this application are true to the best of his knowledge and belief; and that the work will be performed in the mannelr set forth in the application filed therewith. Sworn to before me this .............. .~.' ' 'day °i ..... ~.~..'~..' .' ........... Notary Public .... x ' 'i ............ County i ~ HELEN K. DE V0E NOTARY PUBLIC, State o! New York · · · ....... ; ........ . No, 4707878, Suffolk lerm Expires M~mh 30, lg..~[ (Signature df applicant) 3825 South /tarZgor Rd. Sou~hold, IV~J 11971 765 275~8 Premises at 126~ Wunnewe£a Rd. Nassau Point Properties 2 windows Existing House Porch 15 x30 3 windows 6 windows All windows are Jalousie type with screens ~ doors (2) as above Roof asplhalt shingles over plywood 2 x 6 rafters Gutters 12 electric outlets 8 4 r 4 Posts to support roof 2 foot wall below windows with 2 x 4's Finished plywood Sheetroe£ ceiling IRED THE NEW YORK BOARD OF FIRE UNDERWRITERS BUREAU OF ELECTRICITY I-- 85 JOHN STREET, NEW YORK, NEW YORK 10038 ~A¥ ~a~ Application No. on.file THIS C:ER'rlFIES THAT ~ exami~ ~ .~ound to be in ~m~ian~ ~ith the ~ui~nt. o~ ~h~ ~. RXTUII! RXTUR~S RANGIS OVENS D~SM W~ EXHAUST FANS t 10 1 ] OIIYIRS RJRNACll MOTOIIS 'mAi Ci~OCKS MULTI-QqJTilT DIMMIRS SYSTIMS SilIVIC~ DgSCO4qHqI~CT S E R V I C OTI~ll APPARATUS: $OU'FF{c')I,D~ NY~ :il /] This ce~flcate must not be altered in any manner; return to the office of the Board if incorrect. Ptr .. identified by thor cmdentlab. COPY FQI~ BUILDII4G DEPARTMENT. 'rills COPY OF CERTIFICATE MUST ! ALTB~D IN ~ ~.